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Football Off-Season and Recovering From 'Hits'

Study found some players still showed brain changes 6 months after season had ended

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) -- New research shows that the brains of some football players who had the usual head hits associated with the sport, but no concussions, still had signs of mild brain injury six months after the season ended.

"We followed athletes at the beginning of football season, after and for six months later," said Dr. Jeffrey Bazarian, an associate professor of emergency medicine at the University of Rochester School of Medicine and Dentistry, in Rochester, N.Y.

Bazarian found white matter changes consistent with mild brain injury generally persisted for six months. "When we looked at players individually, there were a few that looked like they did resolve," he said, but half of the players still showed changes at the six-month mark.

"We didn't see these changes in those who don't play football," he said. "And these are the kinds of changes that are being found in retired NFL players."

The latest study is published in the April 16 online issue of PLOS ONE.

For the research, Bazarian evaluated 10 Division III college football players and five college students who did not play sports during the 2011-2012 season. All 15 underwent brain imaging in addition to balance, cognitive (thinking) skills and other testing before the season, at the end of the season and after six months of rest. The athletes were told not to play during the six months, he said, although the researchers can't be sure everyone followed that instruction.

During the football season, accelerometers mounted to the helmets measured head impacts. The total head impacts for the season ranged from 431 to 1,850, but no one got a diagnosis of concussion.

A concussion is a brain injury that disrupts normal functioning. In recent years, experts have told coaches, players and parents that athletes should not return to play until a doctor evaluates them if a concussion is suspected.

In the new study, the athletes had more changes in white matter from the first measurement to the second, and most of these differences remained at the final measure, six months after play had stopped.

The lack of recovery could contribute to the white matter changes that accumulate over the years with repetitive head impacts, the researchers noted.

"We are obviously trying to understand, are these changes the beginning of this process?" Bazarian said. They also need to find out why some brains recover more quickly, he added.

"Inflammation may be at play," Bazarian said. "If that's the case, maybe it's a case of preventing inflammation. Maybe more than six months of rest is needed."

The researchers can't say if the changes are "clinically meaningful," Bazarian said. "We found no changes in balance or cognition."

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